November 25th, 2010 by DrRich in Better Health Network, Health Policy, Humor, Opinion, True Stories
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In what has become a tradition over the past few years, DrRich proudly reprises his annual Thanksgiving message to his beloved readers:
Gathered around the Thanksgiving table, DrRich’s large extended family, carrying out a longstanding tradition, each offered in their turn one reason for being thankful on this most reflective of American holidays. DrRich listened respectfully as each of his loved ones, and each of the ones he was obligated to tolerate benignly because they had married (or in some other manner had committed to) one of his loved ones, recounted a cause for thanks.
There is no need for DrRich to recite their utterances here, because they were all perfectly predictable and fairly mundane, having mostly to do with items such as maintaining good health, finding a job, being able to afford one’s mortgage payments, getting a passing grade in French, receiving a new puppy, Mr. Obama’s remarkable presidency, the apparent continued structural integrity of the Universe despite Mr. Obama’s presidency, etc., etc.
When it was at last DrRich’s turn, he, in retrospect perhaps somewhat inadvisedly, was unable to refrain from displaying his keen insight and superior analytical abilities on matters related to healthcare (a topic, anyone would have to admit, about which most of us would very much like to feel thankful). Lifting his glass, DrRich pronounced that he was most deeply and humbly thankful for the 47 million Americans without health insurance.
And further, especially thankful that their ranks must surely be growing, given the recession, advancing unemployment, imminent collapses of businesses and indeed entire industries, etc. And even though Obamacare promises to significantly reduce that number, DrRich went on to express his fervent wish that large numbers of the uninsured might still be with us a year and two years and even ten years hence, for the great and good benefit of us all. Read more »
*This blog post was originally published at The Covert Rationing Blog*
November 23rd, 2010 by RyanDuBosar in Better Health Network, Health Tips, News, Research
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Kids get inner ear infections and then they get antibiotics, despite a long-standing knowledge that it’s not always best. Any physician knows this, but who hasn’t faced an irate or anxious parent in the exam room insisting on a prescription, whether the evidence warrants it or not?
Reuters reports that the tally for all those antibiotics is $2.8 billion dollars, or $350 per child annually. And there’s only a slight benefit to them.
While hardly comforting to the parents, physicians can add more heft to their argument that antibiotics are only modestly more effective than nothing, and they can avoid the rashes and diarrhea that antibiotics incur. Read more »
*This blog post was originally published at ACP Internist*
November 17th, 2010 by Richard Cooper, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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It is an article of faith that, in Barbara Starfield’s words, adults whose regular source of care is a primary care physician rather than a specialist have lower mortality, even after accounting for differences in income, and she draws upon studies at both the county and state levels to prove it. Now a new paper in JAMA about England’s Primary Care Trusts refocuses the discussion on poverty.
While Starfield’s county-level studies are often cited as evidence that more primary care physicians and fewer specialists lead to lower mortality, they actually showed virtually no differences at all. And when repeated by Ricketts, the small differences noted were not consistent throughout various regions of the U.S. On the other hand, “counties with high income-inequality experienced much higher mortality.” So, in reality, the county studies demonstrated the strong impact of poverty and the marginal impact (if any) of primary care. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
October 27th, 2010 by RamonaBatesMD in Better Health Network, Opinion, Research
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There’s an article in the Oct 20, 2010 issue of the Journal of the American Medical Association (JAMA) which discusses surgical team training and teamwork in the operating room.
Most surgeons have crews or individuals in the operating rooms they prefer to work along side. Things just go smoother. We work more as a team, more as one.
Why? Personalities. Communication styles that work well together. Skills that compliment. Each person knows and does their job, not trying to do someone else’s. Each knowing that even the smallest task is important to the whole.
Ideally, we could create teams like this at all times in the operating room. In reality, its not so easy. Change in personnel happens. Team members get sick, so there is great need for crosstraining and flexibility. Personnel (including surgeons) need to be able to work with these changes.
I know currently the comparison is to racecar teams that change the tires, etc. with great efficiency or the aviation industry with their checklists. While we should learn from these industries, we must not forget that medicine is far more diverse. Surgeries are not all the same. The cars are. Read more »
*This blog post was originally published at Suture for a Living*
September 21st, 2010 by RamonaBatesMD in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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Some interesting items this week involving hands. The one which has gotten much news coverage is the issue of handwashing. Take a look at some of the headlines:
High five! Handwashing on rise (Chicago Sun-Times)
For Many, ‘Washroom’ Seems to Be Just a Name (The New York Times)
93% of women wash their hands vs. 77% of men (USA Today)
All the above are reporting on the same study, but the difference in presentation is amazing to me.
The study doesn’t involve handwashing in a hospital or doctor’s office setting. The JAMA article (2nd reference below) does, but this article focuses on whether public reporting of handwashing compliance is helpful or not. Do we inflate our numbers to make ourselves look better? Read more »
*This blog post was originally published at Suture for a Living*
